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I just had a VIA (visual inspection with acetic acid), and…

I just had a...

I just had a VIA (visual inspection with acetic acid), and they noted white spots on my cervix and asked me to return for further evaluation. What could this be, and what should I be sure to ask?

Doctor's Assistant: When was your last pap smear? Have you ever had an irregular pap?

My last pap was 3 years ago, and it was normal. I have had nabothian cysts before

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I have recurrent UTIs (four or more a year)? Not sure if that affects my cervix in any way

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Answered in 3 hours by:
5/25/2018
Dr. Nina Lim
Dr. Nina Lim, Board Certified MD
Category: Medical
Satisfied Customers: 1,051
Experience: Internal Medicine Physician
Verified

Hello, my name is***** and I am a women's health physician.

So the VIA is a screening test and instead of remaining colorless, the doctor saw some white spots on the cervix which means that the test came back positive and additional testing (cervical biopsy) is necessary.

It is important to note that not all acetowhite lesions are diagnostic of cervical precancer or cervical cancer. Other reasons for these acetowhite lesions include: changes associated with HPV (human papillomavirus) infection, leukoplakia (caused by chronic irritation), or squamous metaplasia.

HPV - human papilloma virus - is a virus that can cause these changes on the cervix. It is a very common infection. A huge percentage of women who are sexually active will get HPV at some point in their lives. Although there is no medication/ treatment specifically to eradicate HPV, the body can eventually get rid of it on its own.

Cervical leukoplakia is a condition in which thick, white patches form on the cervix. It can be due to irritation (rubbing a device on vagina) or again from HPV infection.

Squamous metaplasia of the cervix is a benign non-cancerous change of surfacing lining cells. These changes don't signify a specific disease, but rather usually represent the body's response to stress or irritation. Smoking, vitamin A deficiency can sometimes cause these changes.

So the main thing is to attend to the follow up appointment where you will most likely have a cervical biopsy to find out what these white spots are.

I am available to any follow up questions that you may have.

If you were satisfied with my response, please consider giving me a 5 star rating so I may credit for assisting you, thanks and I wish you all the best.

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Customer reply replied 2 months ago
Hi, I finally got in to see my doctor for the biopsy, but was told they aren't currently performing them as they don't have an available lab connection (I live on a remote island). The doctor said since I'm young (36) and had a normal PAP three years ago, I should be ok to wait a while (several months at least) until they can do biopsies. Is this ok, or should I travel to see another ob/gyn? I'm not sure how I would have gotten HPV if it's that...I had the vaccine series as a virgin, and used protection during the very few intimate encounters I had before being in a monogamous relationship for the last 8 years. I use a menstrual cup, so nothing should be irritating my cervix. I'm a non-smoker. I have had recurrent UTIs and antibiotics to treat them and some digestive issues, but I'm not sure that this would result in the stress/irritation you're referring to. Basically, how long can I wait to follow up on this since I'm not currently able to? And will this affect fertility? I've never had children but plan to in the future.
Your doctor knows you best and if he/ she feels based on your history and risk factors that it is ok to wait, then it is most likely ok. I do not have the answers to your other questions if your are asking about specific time frames and percentage of infertility related to your condition so I will opt out for now to allow other experts to answer your question. I wish you all the best.
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Customer reply replied 2 months ago
Ok, thank you. By 'my doctor', I mean he is the only ob/gyn where I live...there is no other. He did not examine me...the public health nurse did and referred me to him. He's telling me I SHOULD be ok to wait since I'm not as high risk as other patients, because he said cancer would take several years to develop, and because there really isn't another option here. That's why I'm on this site asking questions.
Dr. Ravoof
Dr. Ravoof, Doctor
Category: Medical
Satisfied Customers: 7,042
Experience: Experienced Physician in the field of Medicine and Surgery.
Verified

Dear customer,

Thank you for replying.

Are you able to repeat the Pap smear now since it was done 3 years ago?

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Customer reply replied 2 months ago
I just had a VIA, which is what the hospital here does instead of a PAP smear. The VIA showed acetowhite spots.

Dear customer,

Thank you for replying.

You need a pap smear. The VIA is not a very specific test and nothing can be concluded from these results. So, please get a pap smear done since this screening test needs to be done at least once in 3 years. A Pap test is a very sensitive and specific test and with a normal Pap test, you can safely relax.

Take care.

Please let me know if you have further queries or unanswered

questions.
Please rate the answer with 5-stars, by clicking the 5-stars above

with your mouse (or with your finger on a mobile device).
It will be very generous of you to also consider a bonus.
Thank you!

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Dear customer,
Were you able to read my answer?
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Thank you!

Dr. Ravoof
Dr. Ravoof, Doctor
Category: Medical
Satisfied Customers: 7,042
Experience: Experienced Physician in the field of Medicine and Surgery.
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